Smile Care Claims Technical Onboarding

1

Is your Dental Management Software Cloud-Based or Local?* This field is required.

Cloud Based

Local

Both

3

What Dental Management Software does your practice use?* This field is required.

Dentrix

EagleSoft

Open Dental

Other

4

What Dental Management Software and Cloud-Based Software does your practice use?* This field is required.

Local Software

Cloud-Based Software

5

Schedule Your Onboard* This field is required.

6

Email* This field is required.

example@example.com

7

Office Phone Number* This field is required.

Please enter a valid phone number.

8

Name* This field is required.

First Name

Last Name

9

Doctor/Owner Name* This field is required.

First Name

Last Name

10

Name of Practice* This field is required.

11

Is there anyone else you would like to invite?* This field is required.

YESNO

12

Additional Attendee Name* This field is required.

First Name

Last Name

13

Additional Attendee Email* This field is required.

example@example.com

14

No Appointment Needed* This field is required.Please enter your email address below, and we’ll send you a secure encrypted link to share your cloud-based login credentials safely.

example@example.com